Who Is Eligible for Medi-Cal?

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What Is Medi-Cal?

The California Medical Assistance Program, or Medi-Cal, is California’s version of the Medicaid program. Medi-Cal is a need-based program that offers health care benefits to low-income individuals. Medi-Cal is funded by California state taxes as well as by federal funds. To qualify for Medi-Cal, one must be a California resident.

Who Is Eligible for Medi-Cal?

Coverage under Medi-Cal is based on an individual’s level of financial need. Disability is also a key factor in determining eligibility and coverage. Individuals who fit the following groups may qualify for Medi-Cal:

1. Public Assistance

Those who automatically qualify for Medi-Cal include individuals who are 65 or older, are blind or disabled, and receive Supplemental Security Income (SSI)/State Supplementary Payment (SSP).

2. Medically Needy

Those who are "medically needy" include individuals who are 65 or older, blind or disabled, and meet the family requirements of the California Work Opportunity and Responsibility to Kids (CalWORKs).

3. Medically Indigent

The following people may qualify for Medi-Cal because they are considered medically indigent:

4. Special Programs

The following people may qualify for all or some of the Medi-Cal coverage by fitting into the following groups:

5. Persons with Disability

For an adult to qualify for the Medi-Cal coverage based on disability, the following criteria must be satisfied:

For a disabled child to qualify for the Medi-Cal coverage, the following criteria must be met:

Even before disability is established, a disabled person may qualify for Medi-Cal coverage based on the presumption of his disability.

Assets, Property, and Income: What Matters for Medi-Cal Coverage?

In general, the higher your income, the more you will have to pay towards your medical bills. Concerning assets, Medi-Cal caps the value of the assets an applicant may posses. However, the rules are complex, and certain assets may not be counted. Advanced planning with a qualified lawyer may be the best option.

Should I Contact an Attorney about Medi-Cal Eligibility?

The Medi-Cal application process is complicated and many applicants will not be approved because they make errors such as incorrectly stating their assets. Therefore, you may wish to contact a qualified attorney to help you become eligible for Medi-Cal benefits.

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Last Modified: 01-23-2014 03:21 PM PST

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